As Deakin University Vice-Chancellor Professor Iain Martin said during the graduation ceremony, “Deakin’s commitment to innovation ensures our graduates are equipped to make a difference and help create a better future.”
We wish Emily, Pam, Rami, Stephanie, Tigestu and Hafiz all the best for their future endeavours and look forward to seeing the positive impact you will make on the world.
Dr Emily Cooke
(Dr Emily Cooke pictured with Associate Professor Claire Henderson-Wilson and Dr Elyse Warner)
My thesis is titled ‘An Animal-Assisted Intervention in an Australian university.’ The overall aim was to conduct a formative evaluation of the need for an Animal-Assisted Intervention (AAI) on an Australian university campus and best practice for successful implementation. This was addressed by conducting three phases of research.
The first phase was a scoping review of the literature regarding AAIs in the university setting. The review focused on outcomes associated with an AAI on campus, along with details of implementation and intervention characteristics. The main finding from this review was all previous studies that measured perceived stress, perceived anxiety, mood and campus connectedness found improvements following participation in an AAI.
The second phase was a qualitative study with authors internationally that had previously conducted an AAI on a university campus, in order to determine barriers and facilitators they experienced while implementing the AAI. Participants noted the most important factors when implementing an AAI were making sure all personnel involved understood and approved the AAI, along with ensuring the welfare of both human participants and therapy animals involved. Furthermore, participants highlighted that AAIs on campus were a popular intervention amongst the student cohort.
The third phase was a mixed methods study with Australian university students and staff members in order to determine their interest in an AAI on campus, details of their preferred intervention characteristics, reasons they believe an AAI could be beneficial, and any hesitations towards an AAI on campus. This phase consisted of a descriptive survey and follow up in-depth interviews in order to explain the survey results in more detail. A large majority of participants were enthusiastic towards participating in an AAI on campus. Several considerations regarding intervention characteristics such as the location, frequency and timing on campus, promoting the AAI and how to ensure the welfare of the therapy animals were discussed by participants. Additionally, participants highlighted several strategies for minimising potential hesitations towards an AAI (such as allergies, phobias, religious or cultural views of animals and the AAI being a distraction on campus). How an AAI could collaborate with other health services on campus was also explored by participants.
Overall, findings from my PhD indicate that an AAI may be a positive addition to an Australian university campus. Furthermore, an AAI may fit within an overall approach to promoting health and wellbeing for the university community.
Dr Phuong (Pam) Nguyen
(Phuong (Pam) Nguyen pictured with Emeritus Professor Marj Moodie)
Phuong (Pam) Nguyen’s PhD is about the economic credentials of sedentary behaviour interventions. The core component of her project was to build Australia’s first economic model that use excessive sitting time as a risk factor for chronic disease in modelling. Pam’s work has demonstrated that a small reduction of around 36 minutes per person per day across Australian adult population would result in a substantial health care cost saving of $39 million a year. Interventions targeted desk-based workers in office setting could achieve greater reduction in sitting time, more than 60 minutes per person per day. However, these interventions were costly and did not offer good value for money.
Dr Rami Aldwikat
The overall aim of my research was to identify valid and reliable screening tools for detecting delirium in surgical patients in the Post Anaesthetic Care Unit (PACU) and surgical ward settings.
In phase one, data analysis of the systematic review revealed two tools, the 4AT and the 3D-CAM, are the most accurate screening tools to detect delirium in the PACU. Phase two, the prospective cohort study, provided evidence relating to the validation of two screening tools for detecting delirium in the PACU and surgical ward settings (diagnostic test accuracy study). The 3D-CAM had a sensitivity of 100% (95% CI 92.0 to 100.0) in the PACU and during the first 5 days postoperatively. Specificity ranged from 91% (95% CI 85.9 to 95.2) to 93% (95% CI 87.8 to 95.2) in the PACU and during the first 5 days postoperatively. The 4AT had a sensitivity of 93% (95% CI 81.7 to 98.6) in the PACU and during the first 5 days postoperatively, and specificity ranged from 87% (95% CI 80.9 to 91.8) to 89% (95% CI 84.6 to 93.1) in the PACU and during the first 5 days postoperatively. Furthermore, the association of delirium developed in the PACU with older patients’ ability to perform activities of daily living (ADL) during the first five postoperative days was also explored using the 4A’s Test (4AT) and 3-Minute Diagnostic Interview for the Confusion Assessment Method (3D-CAM), against the gold standard criteria for diagnosis of delirium, the Diagnostic and Statistical Manual of Mental Disorders- fifth edition (DSM-5). Phase three, the qualitative study, provided evidence for the feasibility and clinical utility of two screening tools, the 4AT and the 3D-CAM, for detecting delirium in the PACU and orthopaedic surgical ward settings. In addition, nurses from both the PACU and orthopaedic surgical wards recommended some changes to the content formatting of both tools to increase utilisation of those tools in practice.
Dr Stephanie Hunter
(Dr Stephanie Hunter pictured with Associate Professor Pat Nicholson)
Vasoactive medication management is core business for intensive care nurses worldwide. There is scant evidence on nurse decision-making and clinical practices when managing vasoactive medications, and few evidence-based guidelines or learning resources to support nurses learning to manage vasoactive medications, such as noradrenaline. The aim of the study was to explore nurse decision-making and management of vasoactive medications in the intensive care unit. The Cognitive Continuum Theory provided a framework for the four-phase mixed method study. Study phases included a systematic review, retrospective cohort study, naturalistic observations, semi-structured interviews, and focus groups with 1280 patients, and 35 nurses from two Australian intensive care units. Quantitative and qualitative data generated from 2018-2021 were examined using narrative, statistical and thematic analysis.
Nurses learnt noradrenaline titration and weaning at the beginning of their intensive care careers. High-risk, fast acting medications prescribed to a heterogeneous population of critically-ill patients demanded decision-making intensity. Nurses used both analytical and intuitive decision-making in rapid succession, and self-developed noradrenaline titration strategies. Medication policies developed without nurse input negatively impacted patient safety, and resulted in personal, professional, and moral distress, and loss of practice autonomy for nurses. Findings generated a comprehensive understanding of decision-making, clinical practice, and intensive care contexts for nurses managing vasoactive medications. Patient heterogeneity was linked to practice uncertainty and added complexity to nurse decision-making. Guidelines developed to support nursing practice and decision-making when managing vasoactive medications would facilitate clinical judgement and nursing autonomy.
The study explored nurse decision-making processes, clinical practices, the influence of the patient population, and intensive care contexts when managing vasoactive medications. Intensive care nurses managed vasoactive medications from the start of their intensive care career, necessitating clinical and peer support to overcome physical and social isolation. Nurse-developed titration strategies could provide an evidence base for titration and weaning guideline development.
Dr Tigestu Desse
Under the supervision of Professor Elizabeth Manias and Associate Professor Kevin Mc Namara, Tigestu Desse completed his PhD titled: Development of a complex intervention for effective management of type 2 diabetes in a developing country. Tigestu’s research comprised a three-phase design, involving a systematic review, interviews and focus groups with patients, families, health professionals and policy makers, and development of a complex intervention for effective management of type 2 diabetes in Ethiopia. He utilised the United Kingdom Medical Research Council Framework and the Behaviour Change Wheel Theoretical Framework to design a complex intervention and operationalise intervention components.
Tigestu identified diabetes care was fragmented and hampered by a lack of patient-centeredness. He found contextual complexities relating to the availability of essential diabetes care resources, such as medications, laboratory and diagnostic facilities, and a trained health workforce. He used this information to guide the development of a diabetes care intervention that recognised the care gaps and was tailored to the environmental context and the needs and preferences of patients and health professionals. An individualized behaviour change intervention was created, involving structured diabetes education and counselling and collaborative care of diabetes with health professionals of diverse disciplines, patients, and policymakers.
During his candidature, Tigestu was actively involved in several initiatives at Deakin University. He completed methodological units in advanced biostatistics and qualitative health research, and participated in seminars on methodological and theoretical aspects of implementation science. Aside from presenting his work at national and international conferences, Tigestu also participated in the annual Research School for postgraduate students. Tigestu published five peer-reviewed journal papers during his candidature – four relating to his PhD work, and one comprising a collaborative paper with a Master of Philosophy student.
Since completing his PhD, Tigestu has secured a research position at the Baker Heart and Diabetes Institute.